Volume. 35, No. 2 july. 2011 - The Chest and Heart Association of ...

Chest & Heart Journal Vol. 35, No.-2, July 2011Rationale of the study:Antibodies develop in patients receivingantitubercular drugs rarely.But these antibodiesmay cause immune haemolysis, which causepositive DAT. To prevent interruption of treatmentof tuberculosis due to anaemia or high colouredurine, it is essential to find out the presence ofantibody by DAT. In this study DAT is performedto observe wheather the drug is responsible foranaemia which cause discontinuation of therapy.In the study ABO & Rh grouping is also done toobserve the association between ABO & Rh groupwith positive DAT. Patients of tuberculosis oftentake antitubercular drug irregularly due to eitherhigh cloured urine or different degree of anaemiaor weakness. To continue further treatment it isessential to find out the cause of high colouredurine or anaemia. In this study DAT is performedto observe weather the drug is responsible foranaemia and discontinuation of therapy.Aims and Objectives:General ObjectiveTo observe weather the antitubercular drug isresponsible for positive DAT among patients takingantitubercular drugs.Specific Objectives• To detect drug dependent antibody by directantiglobulin test (DAT) among patientsreceiving antitubercular drugs.• To determine the degree of anaemia amongdrug induced haemolytic anaemia intuberculous patients.TableSerologic Characteristics of Drug-InducedHemolytic AnemiasAutoAB Drug Neoantigenformation adsorption formationDATPolyspecific + + +IgG + + Usually –C3 Usually - Usually - +Serum AbRoutine ± - -Soluble drug ± - +Drug-treated RBC’s ± + +RBC eluate AbRoutine + - -Soluble drug + - -Drug-treated RBC’s + + -*Ab, antibody; DAT, direct antiglobulin test; RBC, red bloodcell.Materials and Methods:It was cross-sectional study. The study was carriedout in the Department of Transfusion Medicine,BSMMU, Dhaka, with collaboration with NIDCH,Mohakhali, Dhaka. Bangladesh. This study wasconducted from July 2009 to June 2010 for a periodof one (1) year. Patients who were diagnosed ascases of tuberculosis of both sexes and who wereadmitted in NIDCH and under antitubercularchemotherapy were enrolled in this study.Selection criteria of subjects:Inclusion criteria:• Diagnosed tubercular patients who wereadmitted in NIDCH and taking anti-tubercularchemotherapy.• History of anaemia and Jaundice.• Patients between 5-70 years of both sexes.• Participants, who gave consent and willing tocomply with the study procedureExclusion criteria:• Diagnosed tuberculous patient who are notadmitted in NIDCH.• MDR and X-DR patient.• Patients who had already positive DAT.• Patients or attendants unwilling to take partin the studySample size was calculated by using appropriateformula. Approximate sample size was 100 of bothsexes after fulfilling the inclusion and exclusioncriteria. Purposive sampling technique was usedDemographic variables:• Age• Sex• Marital status• Religion• Family Member• Monthly income• Level of occupation• Level of educationResidential condition:• Place of residence• Type of house• Type of toilet• Source of water• Overcrowding88